How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $380.19 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $4,168.69 Median $5,623.41 Typical High $10,000.00 | Professional | None | $4,168.69 | $5,623.41 | $10,000.00 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,630.78 Typical High $6,456.54 | Professional | 54 · Surgery only | $2,511.89 | $3,630.78 | $6,456.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $660.69 Typical High $1,202.26 | Professional | 55 · Aftercare only | $467.74 | $660.69 | $1,202.26 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $467.74 Typical High $851.14 | Professional | 56 · Pre-op care only | $331.13 | $467.74 | $851.14 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $4,168.69 Typical High $8,709.64 | Professional | None | $3,630.78 | $4,168.69 | $8,709.64 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $2,691.53 |
Where Rhode Island sits
The same service costs 22.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Rhode Island· 44th of 51
$4,169
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.